Surgical fluid management system

ABSTRACT

A surgical fluid manager includes a pump releasably engageable to tubing and a user interface. The user interface is configured to enable finger-touch selection of a fluid flow rate through the tubing and configured to operate in at least one of a first mode or a second mode. In the first mode, the flow rate is controlled via direct selection of one of a plurality of selectable digital numeric values, while in the second mode the flow rate is controlled via user selection of one alphanumeric identifier within a scale of alphanumeric identifiers. Each respective alphanumeric identifier directly corresponds to just one instrument size within a scale of instrument sizes.

BACKGROUND

The present disclosure relates to fluid management systems. Inparticular, it relates to fluid management systems for medicalappliances, such as a surgical instrument.

Certain surgical appliances use a supply of fluid to irrigate atreatment site on a patient and/or to cool the surgical appliance. Somenon-limiting examples of these types of surgical appliances includemicro-debriders, otologic drills, suction-irrigator instruments and thelike. One common method of providing consistent fluid delivery to asurgical appliance includes pumping fluid from a fluid source, such as abag, through medical tubing via a positive displacement pump, such as aperistaltic pump. Peristaltic pumps are desirable for many reasons, suchas their ability to maintain sterility of the fluid and cleanliness ofthe pump because the fluid flows through the medical tubing and does notcome into contact with components of the pump. In use, tubing is placedwithin the peristaltic pump to allow its rollers to cyclically engagethe tubing to provide the desired pumping action.

Another more traditional method of controlling the flow rate through theirrigation pathway includes a gravity-feed arrangement and the use ofthe ubiquitous, finger-operated, roller-pinch valve. By causing varyingdegrees of a pinching action on the tubing, this roller valveeffectively controls the fluid flow rate. While simple to implement,this method suffers from a lack of consistency and a lack ofpredictability of the flow rate. In particular, a surgeon can waste muchvaluable time during surgery adjusting (or directing a nurses/technicianto adjust) the flow rate via the roller valve to achieve a desired flowrate among different instruments within a single surgery. Moreover, fromone surgery to another, the surgeon (or assisting nurse/technician)cannot readily predict which position of the roller valve will achievethe desired flow rate. Besides the time-consuming nature of thisadjustment method, this variability in controlling the flow rate can bedistracting for the surgeon or nurse/technician, which is typicallymonitoring a host of other instruments and physiologic parameters of thepatient.

Accordingly, conventional fluid delivery systems can hamper surgicalprocedures by failing to provide consistent and predictable control of afluid flow rate from surgery-to-surgery or from instrument-to-instrumentwithin a single surgery.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is perspective view of a system for delivering fluid to asurgical instrument, in accordance with principles of the presentdisclosure;

FIG. 2 is a schematic illustration including a block diagram of a fluidmanager, in accordance with principles of the present disclosure;

FIG. 3A is a graph schematically illustrating a scaled relationship ofpreset flow rates and a progression of successively smaller sizes ofinstruments, in accordance with principles of the present disclosure

FIG. 3B is a graph schematically illustrating a scaled relationship ofpreset flow rates and a progression of successively larger sizes ofinstruments, in accordance with principles of the present disclosure

FIG. 4 is a side plan view of a cutting-irrigator instrument, inaccordance with principles of the present disclosure;

FIG. 5 is a side plan view of a suction-irrigator instrument, inaccordance with principles of the present disclosure; and

FIG. 6 is a flow diagram schematically illustrating a method of managingan irrigation fluid during a medical procedure, in accordance withprinciples of the present disclosure.

DETAILED DESCRIPTION

Embodiments of the present disclosure are directed to controlling fluidflow through tubing to a medical appliance, such as a surgicalinstrument. In general terms, embodiments of the present disclosure canbe used to provide controlled fluid delivery to any medical appliancereceiving fluids via medical tubing. Accordingly, embodiments of theinvention are not limited solely to use with surgical appliances, butcan be employed with a wide variety of medical appliances.

Among other features and configurations, some embodiments of the presentdisclosure provide for a method of performing surgery that includeslocating both a first surgical instrument and a fluid manager within oradjacent to a sterile field. In some embodiments, the fluid managerincludes a console external to the sterile field and a remote control(in electrical communication with the console) within the sterile field.In some embodiments, one or both of the console and remote controlcomprise an electronic touchpad while in other embodiments, one or bothof the console and remote control comprise an array of buttons, wheels,or other electromechanical tools for implementing and adjusting fluidflow control features of the fluid manager.

A flow rate is selected as an independent variable via the fluidmanager. A surgical procedure is performed using the first surgicalinstrument, including directing an irrigation fluid (from a pump locatedexternal to the sterile field) at the flow rate into the tubing andthrough the irrigation conduit of the first surgical instrument. Theirrigation conduit is arranged to direct a fluid onto the treatment siteand/or to cool a cutting tool of the first surgical instrument. It isunderstood that in some instances, the treatment site is a diagnosticsite in which no procedure is performed, while in other instances, aprocedure or surgery is performed at the treatment site.

As noted above, in some embodiments, the remote control of the fluidmanager is located within the sterile field during the procedure. Thisfeature allows the surgeon to retain direct control over the flow rateof the irrigation fluid at the treatment site without necessarilyrequiring the assistance of a nurse or other technician.

In some embodiments, the flow rate is selected and displayed at thefluid manager via digital numeric values. However, in other embodiments,the flow rate is selected via an alphanumeric identifier which isdisplayed at the console and which corresponds to a preset flow rate. Instill other embodiments, the flow rate is selected via one or more icons(which corresponds to a preset flow rate) and then displayed viaalphanumeric identifiers at the console.

In one aspect, the alphanumeric identifier represents a size of thesurgical instrument removably connected to the fluid manager.Accordingly, a surgeon can achieve the proper flow rate for a particularsized instrument by merely selecting, at the fluid manager (via theconsole or the remote control), an alphanumeric identifier thatcorresponds to the size of the surgical instrument. In this way, thesurgeon need not memorize each of the separate flow rates thatcorresponds to a particular size of the surgical instrument nor must thesurgeon rely on the expertise of the nurse to operate a conventionalfinger-operated pinch valve.

Moreover, the fluid manager stores data expressing a scaled relationshipbetween a range of preset flow rates and a range of successively-largersized or successively smaller-sized surgical instruments. In anotheraspect, the respective flow rates within the range are separated by adiscrete interval.

Accordingly, during a procedure involving a suction-irrigator tool, whenthe surgeon chooses to replace the first sized tool with a second,differently sized tool, the surgeon can conveniently use the fluidmanager to select the alphanumeric identifier corresponding to the sizeof the second tool to select the proper flow rate for the procedure.Alternatively, during a procedure involving a cutting-irrigator tool,when the surgeon chooses a tool or replaces a tool, the surgeon canconveniently use the fluid manager to precisely set a flow rateaccording to a digital numerical value. In either case, the selectionscan be made via the console (of the fluid manager) external to thesterile field or can be made via the remote control (of the fluidmanager) positionable within the sterile field (to allow the surgeon tomake the selections directly themselves). It also understood thatreferences herein to a first tool do not necessarily correspond to atool initially used in a procedure but that the terms first tool andsecond tool merely refer to the relative order of two tools used at somepoint during a procedure.

In this way, embodiments of the present disclosure enable a surgeon toachieve and maintain a consistent, predictable fluid flow rate during asurgical procedure.

These embodiments, and other embodiments, are described more fully inassociation with FIGS. 1-6.

A surgical system 10 is shown in FIG. 1, in accordance with principlesof the present disclosure, and includes a mechanism for irrigating atreatment site or cooling a cutting tool of a surgical instrument. Amongother features, the system 10 includes a fluid source (e.g., containers20, 22), tubing set 26, loading cassette 30, console 50, pump assemblies70, and surgical instruments such as cutting-irrigator tool 90 andsuction-irrigator tool 40 (schematically represented in FIG. 1). Fluidstored in containers 20, 22 is supplied via the tubing portions 21, 23for pumping via one of pump assemblies 70 through tubing set 26 tosurgical instrument 40 or 90, as controlled by console 50. Each tubingportion 21, 23 includes a roller-pinch valve 24 adapted to initiate orterminate a gravity-fed transport of fluid out of containers 20, 22. Inone aspect, each tubing portion 21, 23 is removably, fluidly connectedto proximal portion 28 of tubing set 26 while distal portion 29 oftubing set 26 extends to and is fluidly connected to a fluid port 81 ofcutting-irrigator tool 90 or to a fluid port of suction-irrigator tool40 (via adapter 35). It is understood that embodiments of the presentdisclosure are not limited to the particular set instruments describedbut extend to a wider range of surgical instruments.

In general terms, with this arrangement, an irrigation pathway isestablished from containers 20, 22 through tubing portions 21, 23,through proximal portion 28 and distal portion 29 of tubing set 26, andinto an irrigation conduit of one of the respective tools 40, 90.

In another aspect, the pump assemblies 70 are mounted onto the frame 52of console 50 and in some embodiments, are releasably secured relativeto the console 50 to allow convenient replacement of one or more of thepump assemblies 70. In one embodiment, each pump assembly 70 comprises apositive displacement pump having substantially the same features as, orsimilar features to, a Series 313 or 314 Peristaltic Pump available fromWatson-Marlow Bredel Pumps Limited of Cornwall, United Kingdom. In otherembodiments, the pump comprises a pressurized canister pump, a diaphragmpump, or other suitable pump for controlled fluid flow.

In one embodiment, each tubing set 26 includes a loading cassette 30adapted to facilitate convenient and proper loading of the proximalportion 28 of tubing set 26 into releasable engagement relative to theperistaltic pumping mechanism of one of the pump assemblies 70. Onceproximal portion 28 of tubing set 26 is installed via cassette 30, therollers of the peristaltic mechanism of pump assembly 76 releasablyengage the exterior of the tubing to squeeze or pump the fluid throughthe tubing. Among other features, proper loading via cassette 30 insureslongevity of the tubing and enables predictable, consistent fluid flowthrough the tubing. This arrangement, and interaction of, the cassette30, tubing set 26, pump assembly 70, and console 50 is further disclosedin the assignee's co-pending application Ser. No. 12/036,148, entitledMETHOD AND SYSTEM OF LOADING OF TUBING INTO A PUMPING DEVICE, filed Feb.22, 2008, having attorney docket number M190.251.101, and which ishereby incorporated by reference in its entirety. However, it is furtherunderstood that proximal portion 28 of tubing set 26 can be loaded ontoone of the pump assemblies 70 using techniques for loading tools otherthan cassette 30.

In some embodiments, tubing set 26 additionally comprises a dampeningmechanism 32 located in the distal portion 29 of tubing set 26 (i.e.distal of the loading cassette 30) so that dampening mechanism 32 islocated distally of the peristaltic pumping action of pump assemblies70. In one aspect, the dampening mechanism 32 acts to minimizepulsations in the fluid flow that results from the peristaltic pumpingaction. This arrangement smoothes the flow of the fluid as it movesthrough the irrigation pathway without substantially affecting the fluidflow rate. Nevertheless, in other embodiments, tubing set 26 omits adampening mechanism 32 where pulsations in the fluid flow are not ofconcern.

In another aspect, by providing dampening mechanism 32 as part of tubingset 26, the dampening mechanism 32 is separate and independent from pumpassembly 70. This arrangement, in turn, allows the operator to determinewhether or not they would like to employ the smoothing action of thedampening mechanism 32 at the time they select a tubing set. Moreover,by providing dampening mechanism 32 as part of tubing set 26, pumpingassemblies 70 and/or console 50 are unencumbered by a more complexconventional accumulator or dampening mechanism.

As further illustrated in FIG. 1, distal end 33 of tubing set 26 isremovably connectable (as represented by directional arrow B) to fluidport 81 of handpiece 80 for fluidic connection to a surgical instrument,such as a cutting-irrigator tool 90. Alternatively, distal end 33 oftubing set 26 is removably connectable (as represented by directionalarrow C) to a fluid port of another surgical instrument, such as asuction-irrigator tool 40, via adapter 35. In other embodiments, thetubing set 26 could be connected to the surgical instrument withoutusing an adapter.

During a surgical procedure, an operator typically uses acutting-irrigator tool 90 in one hand with the other hand manipulating asuction tool. Alternatively, during a procedure the operator uses adrill in one hand and a suction-irrigator tool 40 in the other hand. Ineither case, the connection of the distal end 33 of tubing set 26 to oneof the tools 40, 90 provides an irrigation pathway to deliver the fluidfor irrigation of the treatment site and/or to cool a cutting tool.

As further illustrated in FIG. 1, cutting-irrigator tool 90 is supportedby handpiece 80 that is removably connectable to port station 54 ofconsole 50. Via port station 54, console 50 supplies handpiece 80 withpower and with control signals to operate a blade or bur ofcutting-irrigator tool 90, as well as providing control signals forcontrolling the pump assemblies 70 to control the flow rate through theirrigation pathway.

Finally, console 50 includes a user interface 60 configured to providecontrol over a fluid flow rate via directing control signals to pumpassemblies 70 and configured to control a cutting action or suctionaction at the respective surgical instruments 40, 90. In one aspect,user interface 60 is a graphical user interface including electronictouchpad capabilities which provide for simultaneous display of and/oractivation of a particular function or feature via the touch of afinger, as further described in association with FIG. 2.

As further illustrated in FIG. 1, in some embodiments system 10additionally comprises a remote control 75 removably connected (via line78) to port station 54 of console 50. In other embodiments, remotecontrol 75 wirelessly communicates with console 50 using RF or infraredcommunication protocols. As further described later in association withFIG. 2, in cooperation with console 50, remote control 75 is configuredto control the fluid flow through tubing set 26 and to suction-irrigatortool 40 or to cutting-irrigator tool 90. In one embodiment, remotecontrol 75 includes an electronic control touchpad configured to allowactivation of a particular function or feature via the touch of afinger, and which may or may not include a graphical display associatedwith the particular function or feature.

In some embodiments, a kit of adapters is provided to quickly connect orlink distal end 33 of tubing set 26 to suction-irrigator tool 40. In oneembodiment, adapter 35 provides the link from tubing set 26 tosuction-irrigator tool 40.

In another aspect, system 10 includes a negative pressure source 95configured to be removably connectable to a suction-irrigator tool 40 toprovide a suction or vacuum at the treatment site. Because a widevariety of tools can be used to employ suction, system 10 is not limitedstrictly to use of the suction-irrigator tool 40 to provide a suctionfunction during a surgical procedure.

With the above general construction of system 10 in mind, a fluidmanager 100 is illustrated in FIG. 2. It is understood that the featuresand components of the fluid manager 100 can be arranged in manydifferent forms and groupings. However, in the illustrated embodiment,fluid manager 100 includes a least a console 150 and a remote control175 that communicates (wired or wirelessly) with console 150. In oneaspect, the wireless communication is performed via RF, infraredcommunication protocols, or other known short range wirelesscommunication protocols.

In one embodiment, fluid manager 100 comprises substantially the samefeatures and attributes as console 50 and remote control 75 of FIG. 1and further comprises the additional features and attributes describedand illustrated in association with FIG. 2. In one embodiment, thefeatures and components of console 150 are provided via a graphical userinterface 60 (FIG. 1) providing electronic control touchpad features,and as such, console 150 provides for simultaneous display and/oractivation of the functions and features presented in FIG. 2. In otherembodiments, console 150 includes one or more thumbwheels, buttons, orother electromechanical control mechanisms for implementing thefunctions of the fluid manager 100.

In one embodiment, as shown in FIG. 2, console 150 includes asuction-irrigator module 160, a cutting-irrigator module 162, memory163, controller 165, a pump selector 166, a mode selector 168, anauxiliary control module 170, and/or a secondary fluid control module350.

In one embodiment, controller 165 comprises one or more processing unitsand associated memories configured to generate control signals directingthe operation of fluid manager 100 of system 10, including control of atleast console 150 and pump assemblies 70. In particular, in response toor based upon commands received via user interface 60 (as graphicallyrepresented by console 150 of FIG. 2) and/or instructions contained inthe memory 163 associated with controller 165, controller 165 generatescontrol signals directing operation of pump assembly 70 to selectivelycontrol the flow rate through the irrigation pathway provided by tubingset 26 and the irrigation conduit.

In some embodiments, remote control 175 is a passive device and is notcontrolled by controller 165. Instead, remote control 175 providessignals from within the sterile field to command the controller 165 ofconsole 150 which is outside the sterile field. In some embodiments,remote control 175 comprises a switched resistor array while in otherembodiments, the remote control 175 comprises capacitive switching,inductive switching, or a combination of capacitive, inductive, and/orresistive switching.

For purposes of this application, in reference to the controller 165 theterm “processing unit” shall mean a presently developed or futuredeveloped processing unit that executes sequences of instructionscontained in a memory. Execution of the sequences of instructions causesthe processing unit to perform steps such as generating control signals.The instructions may be loaded in a random access memory (RAM) forexecution by the processing unit from a read only memory (ROM), a massstorage device, or some other persistent storage, as represented bymemory 163. In other embodiments, hard wired circuitry may be used inplace of or in combination with software instructions to implement thefunctions described. For example, controller 165 may be embodied as partof one or more application-specific integrated circuits (ASICs). Unlessotherwise specifically noted, the controller is not limited to anyspecific combination of hardware circuitry and software, nor limited toany particular source for the instructions executed by the processingunit.

In general terms, the suction-irrigator module 160 is configured toenable selection of a flow rate through tubing set 26 (FIG. 1) andthrough the irrigation conduit of a surgical tool (such as the laterdescribed suction-irrigator tool 400 shown in FIG. 5) for release onto atreatment site. In one embodiment, the suction-irrigator module 160includes a device size selector 200, a micro flow adjuster 220, and asuction module 230.

In one aspect, the device size selector 200 is configured to select aflow rate according to a size of the device removably connected to theconsole 150. In a non-limiting example, the size of the device may beidentified by its cross-sectional area or its outer diameter. The devicesize selector 200 includes various controls, such as a decrease function202, an increase function 204, a display 206, and a unit function 210.In use, an operator manipulates increase function 204 or the decreasefunction 202 to achieve selection of the desired alphanumeric identifiersetting, which is displayed at display 206. In the example shown, thedevice size selector 200 employs the French catheter scale, andtherefore display 206, in combination with unit function 210, displaysthe alphanumeric identifier 8 Fr.

It is also understood that other embodiments, the alphanumericidentifier may be expressed solely as letters (e.g., A, B, C) toidentify a particular size of instrument, while in yet otherembodiments, other combinations of letters and numerals (e.g., A3, A4,etc.) are used to identify a particular size of instrument. Accordingly,the alphanumeric identifier may be an arbitrary representation relativeto the size of the instrument or alternatively may be an indirectexpression of the size of the instrument. In either case, thealphanumeric identifier does not reveal the preset flow rate for anyparticular sized instrument.

In still other embodiments, icons and/or types of graphical indicatorsare displayable and activatable via device size selector 200 (instead ofalphanumeric identifiers) to select the size of the instrument fromamong a range of sizes and thereby indirectly select the fluid flow ratefrom among a range of different fluid flow rates. Like the previouslydescribed alphanumeric identifiers, the icons and/or other graphicalindicators may be an arbitrary representation relative to the size ofthe instrument or alternatively may be an indirect expression of thesize of the instrument. In either case, the icon (or other graphicalindicator) does not reveal the preset flow rate for any particular sizedinstrument.

It is further understood that device size selector 200 is not limited toidentifying instrument sizes via the French catheter scale, but extendsto other units of measure available to identify relative sizing among afamily of instruments. In one aspect, device size selector 200 isconfigured to identify one cross-sectional size within a scale ofcross-sectional sizes of a single type of instrument. In turn, this onecross-sectional size directly corresponds to a particular flow ratewithin a scale of flow rates that provide the proper amount ofirrigation at the treatment site (or cooling of a cutting tool) for thatsingle type of instrument and a particular type of procedure.

Accordingly, it will be apparent to one skilled in the art that thisalphanumeric identifier setting (viewable via display 206) does notindicate the flow rate for the surgical instrument (e.g.,suction-irrigator tool 40 or cutting-irrigator tool 90) that isconnected to console 150. Instead, console 150 includes a pre-programmeddata table within its memory 163 that provides a different preset flowrate for each of the different sizes of the surgical instrument (such asa suction-irrigator tool 40) with each different preset flow rate beinguniquely identified by a different alphanumeric identifier. A graphicalillustration of a relationship between the alphanumeric identifiers thatidentify the respective sizes of the suction-irrigator tools 40 andtheir associated preset flow rates is later described and illustratedfurther in association with FIGS. 3A-3B.

Accordingly, even though the console 150 does not display the actualflow rates setting, the operator need only make a selection of the sizeof the surgical instrument knowing that the console 150 willautomatically select the proper flow rate. In this way, with only thetouch of a single button (via device size selector 200) the operator canhave confidence that the flow rate will be consistent fromprocedure-to-procedure for that sized surgical instrument. In someembodiments, console 150 is configured to additionally or alternativelydisplay the preset flow rates associated with the selected device size.

In one aspect, the ability to select a flow rate for a surgicalinstrument by conveniently entering an alphanumeric identifier provesvery useful in certain surgical procedures in which a series ofsuccessively larger or successively smaller surgical instruments areemployed to gain access to a particular treatment site. In onenon-limiting example, many ENT procedures began with a larger sizedsurgical instrument (e.g. a cutting tool) and then progress to use ofsuccessively smaller surgical instruments as further access is gained tothe treatment site. One such cutting tool includes a cutting-irrigatortool including a blade or bur for providing a debriding action and anirrigation conduit providing irrigation fluid for cooling the cuttingtool and irrigating the treatment site. As the progression occurs fromthe larger instruments to the smaller instruments, the console 150provided in accordance with the principles of the present disclosureautomatically selects the proper preset flow rate for each of thesuccessively smaller instruments, as the operator indicates the size ofthe instrument via the touch of a finger at device size selector 200 ofconsole 150.

This relationship is further illustrated in association with FIGS. 3Aand 3B, which schematically illustrates the scaled relationship betweenthe plurality of preset flow rates and a range of sizes of surgicalinstruments associated with each of those respective flow rates. FIG. 3Aprovides a graph 400 schematically depicting a scale 406 of points 408.Each point 408 represents a particular size of a surgical instrument anda preset flow rate associated with that particular size. In one aspect,an x-axis 404 represents the order in which a series of surgicalinstruments are used in a single procedure. In some embodiments, thesize of the surgical instruments is measured according to a Frenchcatheter scale, while in other embodiments, a different measurement unitor scale identifier is used. In another aspect, the y-axis 402represents a preset flow rate of the fluid for a particular sizedinstrument.

It is also understood that the particular scale shown in FIG. 3A ismerely illustrative and that embodiments of the present disclosure arenot limited to the particular sizes of instruments or to the particularflow rates depicted in FIG. 3A. Nevertheless, in the example shown inFIG. 3A, scale 406 provides a preset flow rate of 40 cc/minute for a 10French sized instrument, a preset flow rate of 35 cc/minute for a 9French sized instrument, a preset flow rate of 30 cc/minute for an 8French sized instrument, and so on. As further illustrated by FIG. 2,the successive flow rates are separated by discrete intervals (e.g., 5cc/minute), so that the change in the flow rate for each differentlysized instrument occurs in a stepwise fashion.

Among other relationships, graph 400 illustrates that the larger sizedsurgical instruments correspond to a larger preset flow rate such thatthe instruments used earlier in the procedure have higher flow rates andthat as the size of the instruments used in succession progressivelydecrease in size, a corresponding decrease in each successive presetflow rate occurs. Because this scaled relationship of the flow rates andinstrument sizes of graph 400 is stored in memory 163 of console 150(FIG. 2), the system automatically sets the proper flow rate upon theoperator indicating the size of the instrument (via the alphanumericidentifier of the device size selector 200).

It is also understood that the operator may alter the order in which thesurgical instruments are used or may skip several sizes any time alongthe scale 406. Nevertheless, the operator will still quickly obtain theproper flow rate for the selected instrument due to the convenientselection mechanism provided via device size selector 200, which enablesselection of the proper preset flow rate via direct selection of thesize of the instrument by use of alphanumeric identifiers.

In a similar fashion, FIG. 3B illustrates a graph 430 depicting a scale436 of discrete points 438 expressing a scaled relationship of presetflow rates (as represented by y-axis 432) and instrument sizes (asrepresented by x-axis 434). In one aspect, graph 430 comprisessubstantially the same features and attributes of graph 400 of FIG. 3Aexcept that, in this embodiment, the order in which the instruments areused corresponds to a procedure in which successively larger instrumentsare used throughout the progression of the surgical procedure (asrepresented by the x-axis 434). Otherwise, graph 430 is substantiallysimilar to graph 400 and illustrates a series of points 438 thatrepresents a plurality of preset flow rates separated by discreteintervals with each preset flow rate directly corresponding to aparticular sized surgical instrument.

Referring again to FIG. 2, in addition to saving time for the operator,as well as ensuring a predictable, consistent flow rate for a particularsize device from procedure-to-procedure, the automatically selectableflow rate also ensures a proper proportion between the flow rate and theamount of suction for a particular sized instrument. Moreover asillustrated in FIG. 2, in some embodiments, a suction module 230 isprovided to enable adjustments to increase (via an increase function236) or decrease (via a decrease function 234) the amount of suction attreatment site via the suction-irrigator tool 40. A display 232 may beprovided to track the relative increase or decrease in the level ofsuction.

In the case of a progression of successively smaller instruments, arelatively smaller amount of suction will be provided for each smallersized instrument so that the amount of suction stays in proportion tothe relatively smaller flow rate of irrigation provided at the treatmentsite for each successively smaller sized instrument. In the case of aprogression of successively larger instruments, a relatively largeramount of suction will be provided for each larger sized instrument sothat the amount of suction stays in proportion to the relatively largerflow rate of irrigation provided at treatment site for each ofsuccessively larger sized instrument. Finally, in another aspect, evenwhen an operator skips around between different sizes of instruments(instead of following a size-by size progression) the appropriate amountof suction will be provided to the particular instrument.

In the event that the operator desires a slightly higher or slightlylower irrigation flow rate, micro flow adjuster 220 enables fine-tuningof the flow rate selected by device size selector 200. In particular,micro flow adjuster 220 includes an on/off button 222, a decrease button224, an increase button 226, and an adjustment display 228. The on/offbutton 222 is configured to enable control over the initiation of, ortermination of, the flow of irrigation fluid via console 150. Thedecrease button 224 and the increase button 226 enable small decreasesand small increases, respectively, away from the macro or basic flowrate set by the device size selector 200. Display 228 provides agraphical indication of the relative increase or decrease in the macroflow rate. In one aspect, this fine tuning adjustment of a preset flowrate for a particular instrument is illustrated in FIG. 3A viadirectional arrow F, which illustrates a small range of increase ordecrease from a pre-selected flow rate (e.g. 20 cc/min) for a 6 Frenchsized surgical instrument.

In some embodiments, each touch of the decrease button 224 or theincrease button 226 of the micro flow adjuster 220 causes a respectivedecrease or increase having a value at least one order of magnitude lessthan an order of magnitude of the increase or decrease in the flow ratecaused by each touch of the decrease button 202 or the increase button204 of the device size selector 200 (i.e., a macro flow adjuster). Inone non-limiting example, buttons 224, 226 of micro flow adjuster 220enable a respective decrease or increase of 5% or 10% a nominal flowrate (one of the macro flow rates selected via device size selector200).

In other embodiments, each touch of the decrease button 224 or theincrease button 226 of the micro flow adjuster 220 causes a respectivepreset decrease or preset increase that is some fraction or percentage(e.g. 1%, 2%, 5%, 7%, 10%, or 15%) of the increase or decrease in theflow rate caused by each touch of the decrease button 202 or theincrease button 204 of the device size selector 200 (i.e., a macro flowadjuster).

In this way, the operator can make small changes or adjustments to thepreset flow rate (selected via the alphanumeric identifier of devicesize selector 200) that corresponds to the size of the surgicalinstrument in use. Accordingly, the operator gains the advantages of apredictable preset flow rate matched to the size of the surgicalinstrument while still retaining the flexibility of adjusting the flowrate up or down from a preset flow rate.

In some embodiments, console 150 also comprises a cutting-irrigatormodule 162 as illustrated in the FIG. 2. This module 162 includes acutting speed module 240, a directional mode selector 250, and a flowrate module 260. The cutting speed module 240 includes an increasefunction 244, a decrease function 242, and a display 246. The increasefunction 244 and the decrease function 242 enable selection andadjustments of the speed of a cutting tool, as typically measured inrevolutions per minute (RPM). The directional mode selector 250 enablesselection of a forward mode or a reverse mode of the cutting tool viathe respective forward function 252 or the reverse function 254. Inaddition, it is understood that cutting-irrigator module 162 (generallyor via directional mode selector 250) also optionally provides selectionto other cutting modes, such as an oscillation cutting mode.

In another aspect, flow rate module 260 of cutting-irrigator module 162provides a decrease function 262 and an increase function 264 to selecta flow rate as a digital numerical value as displayed at display 266. Inthe non-limiting example shown, the flow rate is displayed in cc/minuteunits. By making the flow rate selectable as a digital numerical value,the surgeon can readily achieve a predictable flow rate which can bereproduced from instrument-to-instrument within a procedure, or fromsurgery-to-surgery.

In one embodiment, the flow rate is selected as an independent variable.In other words, the flow rate is not dependent upon another variablesuch as a fluid pressure within a joint (such as an arthroscopicsurgery). Accordingly, once set, the flow rate is not free to vary(unless specifically adjusted to a new constant rate via console 150)below or up to a limit, as occurs in various conventional arthroscopicsurgery systems.

In some environments, the flow rate module 260 also includes a primefunction 268 configured to ready an irrigation conduit for cooling acutting tool or irrigating a treatment site. As noted above, it isunderstood that the term treatment site generally refers to a diagnosticsite, a surgical site, an irrigation site, or combinations thereof.

In further reference to FIG. 2, in some embodiments, fluid manager 100also includes a remote control 175 which is sized and adapted forlocation within a sterile field during a procedure. In one aspect,remote-control includes a pause function 270, a fine adjustment function272, and a coarse adjustment function 280. The pause function 270enables the operator to initiate, terminate or suspend a flow of fluidthrough the irrigation conduit of one of the respective tools 40, 90. Inone embodiment, the pause function 270 is used to control priming orflushing of the irrigation conduit of one of the respective tools 40, 90(FIG. 1).

The coarse adjustment function 280 includes a decrease function 282 andan increase function 284. In one aspect, when the suction-irrigatormodule 160 is in use with a suction-irrigator tool 40 (FIG. 1) or 400(FIG. 5), the coarse adjustment function 280 of remote-control 175functions as a device size selector, substantially similar to the devicesize selector 200 of suction-irrigator module 160 (FIG. 2). Accordingly,the decrease function 282 and the increase function 284 ofremote-control 175 causes a respective decrease or increase in aselection of a size of the instrument by the alphanumeric identifiersselectable via device size selector 200 of console 150. In this way, asurgeon can use a remote control 175 to achieve a proper preset flowrate by merely identifying the size of the instrument to be used.

On the other hand, when the cutting-irrigator module 162 is in use witha cutting-irrigator tool 90 (FIG. 1) or 300 (FIG. 4), the coarseadjustment function 280 of remote-control 175 enables direct selectionof a flow rate according to a digital numeric value in a mannersubstantially the same as flow rate selector 260 of cutting-irrigatormodule 162 (FIG. 2). Accordingly, the decrease function 282 and theincrease function 284 of remote-control 175 causes a respective decreaseor increase in the flow rate as selected by and represented via adigital numeric value.

In another aspect, the fine adjustment function 272 of remote-control175 enables small increases and decreases in a selected flow rate. Forexample, when the suction-irrigator module 160 is in use, a smallincrease in a flow rate made via increase button 276 of remote-control175 corresponds to a small increase made via increase button 226 ofmicro flow adjuster 220 of console 150 (FIG. 2). Likewise a smalldecrease in the flow rate made a decrease button 274 of remote-control175 corresponds to a small decrease made via decrease button 224 ofmicro flow adjuster 220 of console 150 (FIG. 2). On the other hand, whenthe cutting-irrigator module 162 is in use, changes made via thedecrease button 274 and the increase button 276 of remote-control 175correspond to small decreases and increases, respectively, of the baseflow rate selected via flow rate selector 260 of console 150.

In one embodiment, the remote control 175 also can be used to controlthe speed and direction of a cutting tool or drill, such as tool 90. Inthis arrangement, the remote control 175 operates in an auxiliary modein which the coarse adjustment function 280 is used to control thedirection of the drill with activation of the increase function 284 ofthe coarse adjustment function 280 (of remote control 175) causing aforward drill direction and activation of the decrease function 282 ofthe coarse adjustment function 280 causing a reverse drill direction. Inaddition, with the remote control 175 operating in this auxiliary mode,the fine adjustment function 272 of remote control 175 is used tocontrol the speed of the drill with the increase function 274 causing inan increase in the speed and the decrease function 276 causing adecrease in the speed of the drill. In some embodiments, in thisauxiliary mode of remote control 175, the pause function 270 of theremote control 175 is used to reverse the direction (e.g., forward,reverse) of the drill.

In some embodiments, an additional set of an increase function and adecrease function are added to the remote control 175 (in a mannersubstantially similar to the coarse adjustment function 280 of FIG. 2)to allow the remote control 175 to apply controls to both the fluid flowand the drill at the same time. In this other embodiments, the operatorcan toggle between using the remote control 175 to control of the drillor to control the fluid flow.

Console 150 also comprises a mode selector 168 including a cuttingfunction 194 to enable the operator to select fluid management viacutting-irrigator module 162 for a cutting-irrigator tool 90 whilesuction function 196 enables the operator to select fluid management viasuction-irrigator module 160 for the suction-irrigator tool 40. In someembodiments, both the suction-irrigator module 160 and thecutting-irrigator module 162 will be displayed simultaneously on userinterface 60 of console 150, regardless of which function 194, 196 isselected. On the other hand, in other embodiments, just one ofsuction-irrigator module 160 or cutting-irrigator module 162 isdisplayed at a time on console 150 with the mode selector 168determining which of the respective modules 160, 162 is displayed. Inthis latter arrangement, console 150 is convertible between use withsuction-irrigator module 160 or with cutting-irrigator module 162.

In some embodiments, console 150 includes pump selector 166, asillustrated in FIG. 2. The pump selector 166 comprises buttons 190, 192for selecting activation of one or both of the pump assemblies 70 as isappropriate depending upon which fluid containers 20, 22 or other fluidsources are in use.

Referring again to FIG. 2, in some embodiments, console 150 includesauxiliary control module 170, which is configured to provide analternate mechanism to set a flow rate for a surgical instrument. Thisembodiment may prove particularly useful for those users which are morecomfortable with or familiar with keypad entry of various values and/orfunctions, instead of using the suction-irrigator module 160 or thecutting-irrigator module 162. With this in mind, the auxiliary controlmodule 170 includes a keypad 172 configured to allow the entry ofdigital numeric values as well as alphanumeric identifiers. A sizefunction 174 of the auxiliary control module 170 enables a user such asa surgeon to enter a size of the instrument via keypad 172 using analphanumeric identifier to thereby cause an appropriate flow rate forirrigation fluid to travel into (and through) the irrigation conduit ofthe particular instrument. In another aspect, the flow function 176 ofthe ancillary control module 170 enables the surgeon to directly enterthe requested flow rate (for an irrigation conduit of a particularsurgical instrument) as a digital numeric value using keypad 172. In yetanother aspect, the speed function 178 of auxiliary control module 170enables the surgeon (or their assistant) to directly enter a rotationalspeed of a cutting tool of the surgical instrument via keypad 172instead of using the speed selector 240 of cutting-irrigator module 162.Finally, values entered and/or functions selected via auxiliary controlmodule 170 can be displayed on the console via a display like any one ormore of the respective displays 206, 228, 246, and 266 of console 150,as well other display mechanisms forming part of a graphical userinterface such as, graphical user interface 60 of console 50.

In some embodiments, console 150 of fluid manager 100 also includesadditional fluid control modes provided via secondary fluid controlmodule 350 to augment control of fluid flow in addition to selection ofthe fluid flow rate. As illustrated in FIG. 2, secondary flow controlmodule 350 comprises a pulsed flow function 352 and a reverse flowfunction 354. In use, a fluid flow rate is selected via one or more ofthe mechanisms of the fluid manager 100 (FIG. 2), as previouslydescribed. Thereafter, one of the pulsed flow function 352 and/orreverse flow function 354 is selected for use to better implement theselected flow rate.

In one embodiment, the pulsed flow function 352 causes pulsed fluid flowto enable a single nozzle/orifice size of an irrigation conduit todeliver an irrigant stream over a wider flow range and provides bettersurgical sight visibility in at least two ways. First, pulsing the fluidflow via the pulsed flow function 352 interrupts a continuous fluidstream into the treatment site that can otherwise block a surgeon'svision. Second, pulsing the fluid flow provides intermittent no-flowintervals, thereby allowing the surgeon to apply suction at thetreatment site (during the no-flow interval) to remove any pooledirrigation fluid that could otherwise obstruct the surgeon's view of theanatomy at the treatment site.

In one non-limiting example, assuming that a flow rate of 20 cc/minutewere selected, the pulsed flow function 352 would maintain an averageflow rate of 20 cc/minute via intermittent pulses of a substantiallygreater rate of fluid flow (e.g., 50 cc/minute) separated by intervalsof no fluid flow. Accordingly, when applying the pulsed fluid flow, thesame total volume of fluid is directed to the treatment site for periodof time (e.g., a minute) as a non-pulsed fluid flow rate. However, withthe pulsed fluid function, several time no-flow intervals separatesuccessive pulses of fluid flow enabling the greater visibility of thetreatment site and the opportunity for applying suction without ongoingfluid flow.

In one embodiment, upon its activation at console 150 the reverse flowfunction 354 is automatically applied each time that the surgeonselectively stops a flow of irrigation fluid. Accordingly, in additionto the standard stopping action of the pump assembly 70, the reverseflow function 354 causes the pump assembly 70 to additionally implementa brief reversal of the ongoing, forward fluid flow to a direction offluid flow away from the treatment site. This brief reversal issufficient to offset the momentum of the forward fluid flow anddepressurizes the dampening mechanism 32 (FIG. 1) to enable a fasterflow response upon a user request to start and stop fluid flow. Inanother aspect, the reverse flow function 354 also promptly stops anyongoing fluid flow through the tubing (and irrigation conduit), therebyallowing removal (via suction) of any pooled irrigation fluid at thetreatment site while simultaneously preventing dripping from the distalend of the irrigation conduit that could otherwise obstruct a surgeon'sview of small anatomy. In other words, the reverse flow function 354 istantamount to a stop-quickly function with drip prevention. Accordingly,once activated, the reverse flow function 354 is applied automaticallyeach time flow is selectively stopped, regardless of whether thesuction-irrigator tool 40 or the cutting-irrigator tool 90 is being usedby the surgeon. For example, during use of the suction-irrigator tool40, fluid flow is selectively stopped by manually pressing the pausebutton on the remote conrol 175 or on the console, which therebyautomatically triggers application of the reverse flow function 354. Inanother example, during use of the cutting-irrigiator tool 90, each timethe drill of the cutting-irrigator tool 90 is stopped (via a foot pedalrelease or other stopping mechanism), the fluid flow is alsoautomatically stopped according to the reverse flow function 354.

While the surgical instrument used in conjunction with the fluid manager100 of FIG. 2 can take many shapes and forms, one particular surgicalinstrument adapted for use with the cutting-irrigator module 162comprises a cutting-irrigator tool such as a micro-burring instrument300, as illustrated in FIG. 4. The micro-burring instrument 300 isconfigured to optimally perform a sinus surgical procedure, for examplea septoplasty or turbinoplasty procedure. However it is understood thatthe principles of the present disclosure extend to other types ofcutting-irrigator tools and other types of surgeries—both sinus andnon-sinus.

As shown in FIG. 4, the instrument 300 includes an outer tubularassembly 312 and an inner tubular assembly 314 (referenced generally inFIG. 1). The outer tubular assembly 312 includes an outer hub 316 and anouter tubular member 318, whereas the inner tubular assembly 314includes an inner hub 320, and an inner tubular member 322. The innertubular member 322 is sized to be coaxially received within the outertubular member 318 and forms a bur 324 at its distal end. The outertubular member 318 extends distally from the outer hub 316 while theouter hub 316 can assume a wide variety of forms known in the art. Withthis in mind, both inner hub 320 and outer hub 316 are configured forengagement with reciprocating components of a hand piece (e.g. handpiecee.g. in FIG. 1), which in turn, controls high-speed rotation of innertubular member 322 relative to outer tubular member 318. Thisarrangement ultimately results in the high-speed rotation of bur 324,which acts to de-bride or cut target tissue at a treatment site.

Additionally, and in one embodiment, cutting instrument 300 includes anirrigation tube 330 that is exteriorly secured to the outer tubularmember 318. The irrigation tube 330 is configured to convey anirrigation fluid to a working tip of the instrument 300, thereby coolingbur 324 and irrigating the surrounding treatment site. In this oneconfiguration shown in FIG. 4, a connector 340 is provided at one end ofthe irrigation tube 330 and is adapted to fluidly connect the irrigationtube 330 with a fluid source, such as one of the fluid sources 20, 22 inFIG. 1. An opposite, distal end 342 of the irrigation tube 330 isarranged to convey fluid through a wall of the outer tubular member 318to irrigate bur 324 and the surrounding treatment site. Alternatively,the outer tubular assembly 312 can be adapted to internally deliverirrigation fluid via the outer tubular member 318 to cool bur 324 and toirrigate the surrounding treatment site.

FIG. 5 illustrates a suction-irrigator tool in accordance with theprinciples of the present disclosure and which can be provided for useas the suction-irrigator tool 40 shown in FIG. 1. While asuction-irrigator tool can take many forms, in this embodiment, asuction-irrigator instrument 400 comprises a suction portion 402 and anirrigation portion 420. The suction portion 402 defines a suctionconduit 412 extending between a distal end 404 and a proximal end 406. Aconnection portion 408 is defined at the proximal end 406 and isconfigured for connection to a negative pressure source 95 (FIG. 1) viatubing. The amount of suction is controlled via conventional techniques,such as aperture portion 410 of suction portion 402, and/or via thesuction module 230 of suction-irrigator module 160 of console 150 ofFIG. 2. On the other hand, the irrigation portion 420 defines anirrigation conduit 432 extending between a distal end 422 and a proximalend 424. A connection portion 426 is defined at the proximal end 424 andis configured for connection to distal portion 29 of tubing set 26 viaone or more adapters, such as adapter 35 shown in FIG. 1. In this way,irrigation portion 420 forms part of the irrigation pathway extendingfrom fluid containers 20, 22 and tubing set 26.

FIG. 6 provides a flow diagram that schematically illustrates a method500 of surgery in accordance with the principles of the presentdisclosure. In one embodiment, method 500 employs one or more of thesystems or components previously described in association with FIGS. 1-5while in other embodiments method 500 is performed using other systemsor components.

As illustrated in FIG. 6, the method comprises locating both a surgicalinstrument and a remote control of a fluid manager within a sterilefield while locating a peristaltic pump external to the sterile field asshown at block 502. At block 504, via the remote control, the first flowrate is selected as an independent variable expressed as a digitalnumeric value. The method continues with performing a procedure usingthe surgical instrument including directing fluid, via the pump at theselected first flow rate, through tubing and through an irrigationconduit of the surgical instrument for release onto a cutting tip (suchas bur 324 in FIG. 4) and/or onto a treatment site.

Embodiments of the present disclosure provide a system and method inwhich operator can choose a preset flow rate to be assured of aconsistent, predictable flow rate of irrigation fluid at the treatmentsite, whether the surgical instrument is a cutting-irrigator tool or asuction-irrigator tool. In one non-limiting example, finger-touchselection of an instrument size via an alphanumeric identifier causesselection of a flow rate within a scale of preset flow rates. In anotherexample, a preset flow rate is selected as an independent variable andrepresented via in a digital numeric value on a display. Moreover, withthe available remote control feature, the surgeon can readily selectsuch a preset flow rate (directly via a digital numeric value or viaselection of an instrument size) or make small adjustments in the flowrate remotely within the sterile field by the simple touch of a button.

Although the present disclosure has been described with reference topreferred embodiments, workers skilled in the art will recognize thatchanges can be made in form and detail without departing from the spiritand scope of the present disclosure.

1-18. (canceled)
 19. A surgical fluid manager comprising: a positivedisplacement pump releasably engageable to tubing; and a user interfaceconfigured to enable electronic finger-touch selection of a fluid flowrate through the tubing and through a first surgical instrumentconnectable to the tubing, wherein the user interface is configured toconvertibly operate between: a first mode configured to directly controlthe flow rate via user selection of one of a plurality of displayable,selectable digital numeric values; or a second mode configured todirectly control the flow rate via user selection of one alphanumericsize identifier within a scale of displayable alphanumeric sizeidentifiers, wherein each respective alphanumeric size identifierdirectly corresponds to just one surgical instrument size within a scaleof different surgical instrument sizes, and wherein the differentsurgical instrument sizes relate to substantially the same type ofsurgical instrument, including the first surgical instrument. 20.(canceled)
 21. The surgical fluid manager of claim 19 wherein therespective surgical instrument sizes are determined by a cross-sectionalarea of a respective one of the surgical instruments and wherein eachrespective surgical instrument includes an irrigation conduit throughwhich the fluid flows.
 22. The surgical fluid manager of claim 19wherein the user interface comprises: a console positionable external toa sterile field and supporting the positive displacement pump; and aremote control in communication with the console and positionable withinthe sterile field, wherein the remote control is separate from andindependent of the respective surgical instrument, wherein both theconsole and the remote control provide the electronic finger-touchselection of the flow rate via one of the respective first and secondmodes.
 23. The surgical fluid manager of claim 22 wherein the userinterface, including both the console and the remote control, comprises:an adjustment mechanism configured to cause at least one of an increaseor a decrease in the selected flow rate by a numeric value via discreteintervals of at least one order of magnitude less than the order ofmagnitude of the selected flow rate.
 24. The surgical fluid manager ofclaim 19 wherein in the second mode, the flow rate is selectable via thealphanumeric size identifiers in correspondence with performing asurgical procedure using at least one of successively larger surgicalinstruments or successively smaller surgical instruments throughout theprocedure in which each successive alphanumeric size identifiercorresponds to the next instrument size for the procedure.
 25. Asurgical fluid manager comprising: a positive displacement pumpreleasably engageable to tubing; and a user interface configured toenable electronic finger-touch selection of a fluid flow rate throughthe tubing and through a first surgical instrument connectable to thetubing, wherein the user interface is configured to directly control theflow rate via user selection of one of a plurality of displayable,selectable digital numeric values, wherein the user interface includes:a console positionable external to a sterile field and supporting thepositive displacement pump; a remote control in communication with theconsole and positionable within the sterile field, wherein the remotecontrol is separate from and independent of the respective surgicalinstrument; wherein both the console and the remote control provide theelectronic finger-touch selection of the flow rate; and a displayable,adjustment mechanism configured to cause at least one of an increase ora decrease in the selected flow rate, via the console or the remotecontrol, by a numeric value via discrete intervals of at least one orderof magnitude less than the order of magnitude of the selected flow rate.26. A surgical fluid manager comprising: a positive displacement pumpreleasably engageable to tubing; and a user interface configured toenable electronic finger-touch selection of a fluid flow rate throughthe tubing and through a first surgical instrument connectable to thetubing, wherein the user interface is configured to directly control theflow rate via user selection of one alphanumeric size identifier withina scale of displayable, alphanumeric size identifiers wherein eachrespective alphanumeric size identifier directly corresponds to just onesurgical instrument size within a scale of different surgical instrumentsizes, wherein the different surgical instrument sizes relate tosubstantially the same type of surgical instrument, including the firstsurgical instrument.
 27. The surgical fluid manager of claim 26 whereinthe user interface is configured to enable selection of the flow ratevia the alphanumeric size identifiers in correspondence with performinga surgical procedure using at least one of successively larger surgicalinstruments or successively smaller surgical instruments throughout theprocedure in which each successive alphanumeric size identifiercorresponds to the next instrument size for the procedure.
 28. Thesurgical fluid manager of claim 26, comprising: a displayable,adjustment mechanism configured to cause at least one of an increase ora decrease in the selected flow rate by a numeric value via discreteintervals of at least one order of magnitude less than the order ofmagnitude of the selected flow rate.
 29. The surgical fluid manager ofclaim 28, wherein the user interface includes: a console positionableexternal to a sterile field and supporting the positive displacementpump; a remote control in communication with the console andpositionable within the sterile field, wherein the remote control isseparate from and independent of the respective surgical instrument; andwherein both the console and the remote control provide the electronicfinger-touch selection of the flow rate.
 30. A surgical fluid managercomprising: a positive displacement pump releasably engageable totubing; and a user interface configured to enable electronicfinger-touch selection of a fluid flow rate through the tubing andthrough a first surgical instrument connectable to the tubing, the userinterface configured to convertibly operate between: a first modeconfigured to control the flow rate via user selection of one of aplurality of displayable, selectable digital numeric values; or a secondmode configured to control the flow rate via user selection of onealphanumeric identifier within a scale of displayable, alphanumeric sizeidentifiers wherein each respective alphanumeric size identifierdirectly corresponds to just one surgical instrument size within a scaleof different surgical instrument sizes, wherein the different surgicalinstrument sizes relate to substantially the same type of surgicalinstrument, including the first surgical instrument, and wherein theuser interface includes: a console positionable external to a sterilefield and supporting the positive displacement pump; a remote control incommunication with the console and positionable within the sterilefield, wherein the remote control is separate from and independent ofthe respective surgical instrument, wherein both the console and theremote control provide the electronic finger-touch selection of the flowrate via one of the respective first and second modes; and an adjustmentmechanism configured to cause at least one of an increase or a decreasein the selected flow rate by a numeric value via discrete intervals ofat least one order of magnitude less than the order of magnitude of theselected flow rate.
 31. The surgical fluid manager of claim 30 whereinthe respective surgical instrument sizes are determined by across-sectional area of a respective one of the surgical instruments andwherein each respective surgical instrument includes an irrigationconduit through which the fluid flows.
 32. The surgical fluid manager ofclaim 30 wherein in the second mode, the flow rate is selectable via thealphanumeric size identifiers in correspondence with performing asurgical procedure using at least one of successively larger surgicalinstruments or successively smaller surgical instruments throughout theprocedure in which each successive alphanumeric size identifiercorresponds to the next instrument size for the procedure.
 33. Asurgical fluid manager comprising: a positive displacement pumpreleasably engageable to tubing; and a user interface configured toenable electronic finger-touch selection of a fluid flow rate throughthe tubing and through a first surgical instrument connectable to thetubing, wherein the user interface is configured to convertibly operatebetween: a first mode configured to directly control the flow rate viauser selection of one of a plurality of displayable, selectable digitalnumeric values; or a second mode configured to directly control the flowrate via user selection of one icon within a scale of displayable icons,wherein each respective icon directly corresponds to just one surgicalinstrument size within a scale of different surgical instrument sizes,and wherein the different surgical instrument sizes relate tosubstantially the same type of surgical instrument, including the firstsurgical instrument.